Agrawal Tanushree, Irani Malcolm, Fuentes Rojas Stephanie, Jeroudi Omar, Janjua Ejaz
Internal Medicine, Houston Methodist Hospital, Houston, USA.
Cardiology, Debakey Heart and Vascular Center, Houston Methodist Hospital, Houston, USA.
Cureus. 2019 Nov 26;11(11):e6234. doi: 10.7759/cureus.6234.
Gemella haemolysans is a gram-positive coccoid, facultative anaerobe of the mucous membranes. In rare cases, it has been identified as an opportunistic pathogen in the development of endocarditis. Here, we describe a case of infective endocarditis in a patient with a bicuspid aortic valve. A 38-year-old man presented with the complaint of exertional dyspnea of one month duration. He was found to have leucocytosis and his blood cultures grew Gemella haemolysans. Trans-esophageal echocardiography showed a bicuspid aortic valve with 1.5 x 1.5 cm vegetative mass, severe aortic regurgitation, and an aortic root abscess. The patient was started on intravenous ampicillin and gentamycin. He then underwent mechanical aortic valve replacement and bovine reconstruction of the left ventricular outflow tract. Our case highlights the importance of considering atypical pathogens as causative agents of infective endocarditis.
溶血孪生球菌是一种革兰氏阳性球菌样的、存在于黏膜的兼性厌氧菌。在罕见情况下,它已被确定为心内膜炎发展过程中的一种机会致病菌。在此,我们描述一例患有二叶式主动脉瓣的患者发生感染性心内膜炎的病例。一名38岁男性因持续一个月的劳力性呼吸困难前来就诊。发现他有白细胞增多症,其血培养结果显示有溶血孪生球菌生长。经食管超声心动图显示一个二叶式主动脉瓣,伴有一个1.5×1.5厘米的赘生物、严重的主动脉瓣反流以及一个主动脉根部脓肿。该患者开始接受静脉注射氨苄西林和庆大霉素治疗。随后他接受了机械主动脉瓣置换术以及左心室流出道的牛心包重建术。我们的病例强调了将非典型病原体视为感染性心内膜炎致病因素的重要性。